The coronavirus is poised to hit many of Dallas’ most vulnerable neighborhoods the hardest — places where most residents are poor, black or Hispanic, and in dire need of better health care.
That new finding comes from researchers at the University of Texas Health Science Center at Houston, who analyzed federal health and demographic data in partnership with The Dallas Morning News and NBC5.
The researchers identified Dallas neighborhoods where residents who contract COVID-19 will be more likely to end up in the hospital — and possibly in intensive care or on a ventilator. That’s because these areas have the largest share of people with diabetes, heart disease and other chronic health problems associated with severe COVID-19 cases. Also at risk: people ages 60 and older with one or more underlying health problems.
The researchers first did this analysis for Houston. Then, at NBC5′s request, they did a similar analysis for Dallas, where two trends stood out.
First, many of the neighborhoods with the highest concentration of health problems were concentrated in the south-central part of Dallas. Second, many of these neighborhoods are also among the city’s poorest.
“Mapping it makes such a difference. You’re able to see the pattern fairly clearly,” said Stephen Linder, director of the science center’s Institute for Health Policy. He and his fellow researchers, Dritana Marko and Thomas F. Reynolds, hope the results will also help local health officials decide where to target their efforts and resources.
The maps underscore a longstanding geographic disparity that Dallas-area leaders say they’re aware of and trying to fix — both for the immediate threat of COVID-19 and for the long haul.
“This is the population that's going to suffer most. And that's why we really are concerned about putting the resources in and supporting this area as much as we can,” said Philip Huang, director of Dallas County Health and Human Services.
Last year, the county and Parkland Health & Hospital System identified five ZIP codes in southern Dallas as the county’s unhealthiest. In recent years, Parkland — the public hospital system that serves Dallas County’s indigent residents — has provided more services in these and other needy areas.
Many of these same neighborhoods are at risk for severe COVID-19 cases, the researchers at UT Health Science Center found.
Mapping vulnerable neighborhoods
Edgar Love, 68, lives in one of the city’s oldest African-American communities, the Queen City neighborhood of South Dallas. It’s one of the high-risk areas that the researchers identified.
Love said he’s trying to stay inside as much as possible to avoid contracting COVID-19. When he does venture out, he wears a mask.
With no family medical clinic nearby, Love said he travels 10 miles to see his doctor. “I have to go to where they are,” he said. “I don't mind going, but I'd be much better if it was in my community. And many more people in my community would access it.”
That’s one of the problems confronting the neighborhoods highlighted in the study: The residents who have multiple health problems often lack good medical care or access to doctors nearby. Plus, Texas is among more than a dozen states that have not expanded Medicaid under the Affordable Care Act. So many low-income residents have no health insurance.
“That means they're not going to the doctor. And that today's high blood pressure becomes tomorrow's heart attack. Today's high blood sugar becomes tomorrow's diabetes,” said Dallas County Judge Clay Jenkins.
The News also found that these neighborhoods tend to be located farther from hospitals.
People with diabetes, heart disease or other health problems aren’t more likely to contract COVID-19. But if they do get infected, they’re more likely to have a severe case, the kind that could eventually overwhelm hospitals and medical providers here.
Given that trend, the UT Health Science Center researchers used data from the federal Centers for Disease Control and Prevention that estimate the prevalence of seven health problems in a given neighborhood: heart disease, stroke, chronic obstructive pulmonary disease (COPD), asthma, diabetes, obesity and kidney disease.
The researchers ranked every census tract in Dallas for each of those conditions. The areas most at risk of severe COVID-19 cases are those that ranked high on three or more conditions. The researchers also mapped areas with a large share of older residents (ages 60 and up) and high prevalence of at least three health problems.
“We’re worried as the COVID-19 multiplies through the population, that more and more people who have chronic disease are going to need to be hospitalized. And we don’t necessarily have the capacity to deal with all of that need if it all comes at once,” Linder said.
Identifying these higher-risk areas can be vital in helping local officials prepare, he said.
“Once they’re mapped out, then we can target our resources better, we can target our efforts at the populations most likely to place demand on the hospital care system.”
Taking action
County officials say they’re working to make sure all residents, no matter where they live, can be protected against COVID-19 and receive treatment and hospital beds if they’re infected. For instance, of the two testing facilities in Dallas County, one is at Ellis Davis Field House, in one of the high-risk areas identified on the UT Health Science Center map.
Officials say they’re also doing lots of community outreach in those areas, with workers walking the streets, talking with shop owners and making sure people are keeping the proper social distance.
To those who live in vulnerable areas highlighted in the study, County Judge Jenkins said he had a message: “We are working to flood your area with the help that you need … so that you are not mistreated once again as you have been on so many things in this state.”
Senior computational journalist Ariana Giorgi contributed to this story.
